THE SOURCE BLOG

Rate Regulation

This coming election, Palo Alto and Livermore voters will decide whether to cap health care pricing to 115% of direct patient care and quality improvement costs. Officially known as the Accountable and Affordable Health Care Initiative, and colloquially as Measure F for Palo Alto and Measure U for Livermore, these local initiatives face opposition from opponents who assert that federal and state laws preempt and invalidate the measures. On its face, this could have spelled the end to these measures. Preemption is a tried and true way to overturn local …

Prescription drug spending remains an important issue to many Americans. According to a poll by the Kaiser Family Foundation, the affordability of prescription drugs is the top health care priority for voters.[1] In response to public outcry, many states have taken up the mantle of improving affordability and access to prescription medications. In 2018, only two states with legislative sessions, South Carolina and Alabama, did not consider legislation with the aim of reducing prescription drug costs or access. Forty-four states[2] introduced bills and twenty-nine states passed legislation to increase oversight …

Year two of California’s 2017-2018 legislative session continues to be an active one with the introduction of new innovative healthcare bills. As lawmakers work diligently, this month’s California Legislative Beat continues to look at some 2018 bills that can potentially change the California healthcare landscape. AB 2499: This bill would increase the medical loss ratio (MLR) by 5%, from 85% to 90% for a health plan or health insurer in the large group market, and from 80% to 85% for a health plan or health insurer in the individual market. …

On February 16, 2018, California State Assembly Member Ash Kalra introduced Assembly Bill 3087 – The Health Care Price Relief Act, which calls for a commission to set uniform rates for medical providers, including hospitals and physicians, for the private-insurance market. The bill sets the floor for payment at the Medicare rate and places the onus on providers to apply for adjustments to the base amount.[1] AB 3087 advanced out of committee on April 25, 2018, but faces fierce opposition from doctors and hospitals, among other groups.[2] In this post, The Source …

The Source recently contributed to a white paper published by the National Academy for State Health Policy (NASHP) that weighs in on whether state drug rate-setting legislation violates patent law. The Source’s Managing Editor Amy Y. Gu and Senior Research Fellow Katie Gudiksen, along with a team of legal experts at the Institute for Innovation Law at the University of California Hastings College of the Law, explored in States’ Rights: A Patent Law Analysis of NASHP Rate Setting Model Act what states can do to address the rising cost of …

By Guest Blogger: Erin C. Fuse Brown, JD, MPH We are pleased to publish another excellent post by Professor Fuse Brown, originally published here by the Center for Law, Health & Society! The post: Last month, Slate columnist Reihan Salam wrote a provocative article about outrageous hospital prices that are driven, according to Salam, by greed, avarice, and market power. Salam gets a few things dead right, namely his diagnosis that we have a massive hospital pricing problem that is bleeding us dry and that the problem is largely caused by growing hospital market power. However, he misses the …